The Cost-Effectiveness and Budget Impact of Remdesivir for Treatment of COVID-19 in Canada health system
Based on 2022 data, which represented a year of the pandemic when a large proportion of the population in Canada was infected with COVID-19, Health Canada released the following two reports aimed at estimating the impacts of providing remdesivir in two different settings - inpatient and outpatient treatment for COVID-19 - on health system costs and health outcomes.
The Cost-Effectiveness and Budget Impact of Remdesivir for Outpatient Treatment of COVID-19
Overall, they found that outpatient use of remdesivir may be cost-effective across a range of uptakes and cohorts. However, the scenario with the best mean iNMB and budget impact, was the scenario focused on high-risk cohorts (those aged ≥ 65 years and those in LTC) with moderate uptake. Key parameters that may impact these results include the therapeutic effects estimates of remdesivir on hospitalization admission and how this may change with new variants, remdesivir costs, inpatient costs, and lifetime QALY loss associated with mortality from COVID-19.
The Cost-Effectiveness and Budget Impact of Remdesivir for Inpatient Treatment of COVID-19
Overall, they found that inpatient remdesivir may be cost-effective, with probabilistic sensitivity analysis results demonstrating that at a WTP threshold of $50,000, 75% of model simulations found remdesivir to be costeffective across all scenarios. However, we also found that inpatient remdesivir is likely to cost the health system money, with the mean BIA for all scenarios being greater than 0. Key parameters that may impact these results include the therapeutic effects estimates of remdesivir on mortality and LOS, remdesivir costs, inpatient costs, and lifetime QALY loss associated with mortality from COVID-19. Our results were consistent with the findings from the literature from a number of countries, which found that at a WTP of $50,000 per QALY gained remdesivir for inpatients was likely to be cost-effective.1